What If? A series of healthcare ideas worth talking about


This series puts forward tangible policy options for addressing the sustainability of Canada’s healthcare. It presents possibilities and opportunities for improving efficiency and providing additional revenue.

On July 10, 2011, these options were presented to an international audience gathered in Toronto for the annual iHEA conference. They were selected by the presenters themselves, who are also authors of knowledge syntheses about healthcare financing that were commissioned by CHSRF (many other options are presented in their syntheses, which you will also find here).

Reinhard Busse, head of the European Observatory’s Berlin hub, and Peter C. Smith, co-director of the Centre for Health Policy at the Institute of Global Health Innovation, commented on these presentations. Subsequent discussion—which included more than 100 participants in attendance—was guided by Adalsteinn Brown, the Dalla Lana Chair of Public Health Policy at the University of Toronto and a former assistant deputy minister for strategy at the Ontario Ministry of Health and Long-Term Care.

Pharmaceutical pricing options

What if: A health impact fund rewarded innovation and managed spending on new drugs?

Aidan Hollis, Department of Economics, University of Calgary     

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What if: The entry of new pharmaceuticals was managed and their prices were negotiated based on value for the country as a whole, by using existing Health Technology Assessment capacity?

Chris G. Cameron, CADTH (Canadian Agency for Drugs and Technologies in Health)

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What if: A sliding scale were used to reimburse generic drugs to effectively drive down prices?

Aidan Hollis, Department of Economics, University of Calgary  

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Payment options

What if: The price of new provider fees reflected the value of the service and were coordinated across Canada, supported by existing HTA capacity?

Don Husereau, University of Ottawa  

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What if: Group-based profit-sharing strategies aligned physician incentives with the priorities of hospitals and policy-makers?

Pierre-Thomas Léger, HEC Montréal

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What if: Financial incentives were better aligned across hospital and community settings by combining activity-based funding and global budgets?

Trafford Crump, University of British Columbia

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Revenue-generating options

What if: Medical saving accounts were established?

Raisa B. Deber, University of Toronto

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What if: Social insurance could pay for prescription drugs?

Sara Allin, University of Toronto

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